Neurological manifestations by sex and age group in COVID-19 inhospital patients

Daniella Nunes Pereira, Maria Aparecida Camargos Bicalho, Alzira de Oliveira Jorge, Angélica Gomides dos Reis Gomes, Alexandre Vargas Schwarzbold, Anna Luiza Homan Araújo, Christiane Corrêa Rodrigues Cimini, Daniela Ponce, Danyelle Romana Alves Rios, Genna Maira Santos Grizende, Euler Roberto Fernandes Manenti, Fernando Anschau, Fernando Graça Aranha, Frederico Bartolazzi, Joanna d.Arc Lyra Batista, Julia Teixeira Tupinambás, Karen Brasil Ruschel, Maria Angélica Pires Ferreira, Pedro Gibson Paraíso, Silvia Ferreira AraújoAntonio Lucio Teixeira, Milena Soriano Marcolino

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Neurological manifestations have been associated with a poorer prognosis in COVID-19. However, data regarding their incidence according to sex and age groups is still lacking. Methods: This retrospective multicentric cohort collected data from 39 Brazilian hospitals from 17 cities, from adult COVID-19 admitted from March 2020 to January 2022. Neurological manifestations presented at hospital admission were assessed according to incidence by sex and age group. Results: From 13,603 COVID-19 patients, median age was 60 years old and 53.0% were men. Women were more likely to present with headaches (22.4% vs. 17.7%, p < 0.001; OR 1.36, 95% confidence interval [CI] 1.22–1.52) than men and also presented a lower risk of having seizures (OR 0.43, 95% CI 0.20–0.94). Although delirium was more frequent in women (6.6% vs. 5.7%, p = 0.020), sex was not associated with delirium in the multivariable logistc regresssion analysis. Delirium, syncope and coma increased with age (1.5% [18–39 years] vs. 22.4% [80 years or over], p < 0.001, OR 1.07, 95% CI 1.06–1.07; 0.7% vs. 1.7%, p = 0.002, OR 1.01, 95% CI 1.00–1.02; 0.2% vs. 1.3% p < 0.001, OR 1.04, 95% CI 1.02–1.06), while, headache (26.5% vs. 7.1%, OR 0.98, 95% CI 0.98–0.99), anosmia (11.4% vs. 3.3%, OR 0.99, 95% CI] 0.98–0.99 and ageusia (13.1% vs. 3.5%, OR 0.99, CI 0.98–0.99) decreased (p < 0.001 for all). Conclusion: Older COVID-19 patients were more likely to present delirium, syncope and coma, while the incidence of anosmia, ageusia and headaches decreased with age. Women were more likely to present headache, and less likely to present seizures.

Original languageEnglish (US)
Article number100419
StatePublished - Sep 2022
Externally publishedYes


  • Age
  • COVID-19
  • Delirium
  • Neurological manifestations
  • Sex

ASJC Scopus subject areas

  • Neurology


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